OsteoStrong is another international franchise with hundreds of centers across five countries, including the United States, Canada, and Australia. In recent years, it has come under fire. A study evaluating the effectiveness of its program for postmenopausal women with osteoporosis has sparked debate among experts in the field. In February, the Journal of Clinical Endocrinology & Metabolism (JCEM) accepted a research letter showing that bone density improves in patients taking insulin. These positive impacts were made by participants who remained in the program for a full 12 months.
The OsteoStrong program is designed to build bone strength by putting participants through a series of controlled, impactful movements. At the time, the franchise dubbed the study “groundbreaking.” It discovered that the participants who utilized the program showed an increase in bone density versus those who did not access the program. In addition, the study indicated that OsteoStrong increased the effectiveness of osteoporosis drugs for those who were on them.
That favorable reception soon gave way to blistering criticism. In March, Osteoporosis Canada expressed serious concerns about both the study’s findings and the evidence base supporting OsteoStrong’s program.
Questions Raised About Methodology
Read more from University of Alberta Professor Robin Daly and Lora Giangregoria, bone researcher at the University of Waterloo, on why they’re worried. They are justifiably upset with the study’s methodology. They sent a letter to the editor of JCEM calling for a retraction, citing “potential unacknowledged conflicts of interest” and a lack of appropriate ethics approval.
“The claims [of the study] are totally misleading. They’re not supported by the data,” – Professor Daly.
The researchers insist that providing participants the choice of which group they would be in presented nontrivial bias. As Professor Fiatarone Singh, one of the co-authors, explains, this design deficiency renders the findings invalid.
“It doesn’t look like it was rigorously conducted,” – Chris Maher.
Other experts sounded alarms about the way statistics were reported in the study, adding an additional layer of complexity to its interpretation.
“The way that they present the statistics actually doesn’t make any sense,” – Professor Lora Giangregoria.
Osteoporosis Canada’s Position
Osteoporosis Canada strongly discourages the use of the OsteoStrong program as a treatment to promote fracture prevention. That position is due to their assessment of the state of science. Their position shows the other huge gulf between evidence-based medicine and the claims coming out of OsteoStrong and its franchisee.
Despite the overwhelmingly negative criticism, Perry Eckert, OsteoStrong Australia’s managing director, passionately defended the program. He mentioned unpublished studies that he says demonstrate dramatic increases in bone mineral density in postmenopausal women with osteoporosis. Continuation of this research was funded in part by the company under study.
“Following a detailed editorial assessment, we confirmed the need for significant revisions,” – Endocrine Society.
Yet the Endocrine Society has repeatedly criticized the quality of the research. This concern has major ramifications for our clinical practice.
The Need for Rigorous Evidence
Many experts agree that quick-fix solutions such as a 10-minute-a-week program must be substantiated by rigorous scientific studies before being widely adopted. Bioethicist Dr. Shoshana Sztal-Mazer underscored this perspective. Her position was that we should be highly doubtful of claims about these kinds of programs unless there’s good evidence.
“So if somebody’s going to propose a 10-minute-a-week quick fix, it really does need to be proven by rigorous studies,” – Dr. Shoshana Sztal-Mazer.
Critics have echoed similar sentiments about the need for comprehensive evidence supporting any health intervention, especially one aimed at managing conditions like osteoporosis that significantly impact quality of life.
